内镜下黏膜剥离术治疗早期胃癌及癌前病变的疗效观察

Observation on the Therapeutic Effect of Endoscopic Submucosal Dissection in the Treatment of Early Gastric Cancer and Precancerous Lesions

摘要: 目的：对延安大学附属医院实施内镜下黏膜剥离术(ESD)治疗早期胃癌及癌前病变的效果进行评价。方法：对延安大学附属医院2023年1月1日至2024年6月30日收治的120例行ESD治疗的早期胃癌(ECG)及癌前病变(PL)患者的临床资料作回顾性总结，分析ESD治疗ECG及PL的有效性和安全性。结果：120例ECG、PL患者，手术年龄为(60.53 ± 7.58)，病灶大小为(1.47 ± 0.49) cm，手术时间为(45.7 ± 15.34) min，患者住院时间为(4.8 ± 1.3) d，治愈性切除率为94.2% (113/120)。发生急性出血5例，延迟性出血2例，无穿孔、狭窄发生，并发症发生率为5.83% (7/120)。随访6个月时内镜复查，创面愈合率为100%。随访1年无复发。结论：ESD治疗早期胃癌及癌前病变具有微创、恢复快、并发症少、住院时间短等优点，适合在具备条件的医院推广。

Abstract: Objective: To assess the efficacy of endoscopic submucosal dissection (ESD) in the management of early gastric cancer (EGC) and precancerous lesions (PL) at the Yan’an University Affiliated Hospital. Methods: The clinical data of 120 patients with early gastric cancer (ECG) and precancerous lesions (PL) who underwent ESD treatment in the Yan’an University Affiliated Hospital from January 1, 2023 to June 30, 2024 were retrospectively summarized to analyze the efficacy and safety of ESD in the treatment of ECG and PL. Results: Among the 120 patients with ECG and PL, the average age at surgery was (60.53 ± 7.58) years, the lesion size was (1.47 ± 0.49) cm, the operation time was (45.7 ± 15.34) minutes, the hospital stay was (4.8 ± 1.3) days, and the curative resection rate was 94.2% (113/120). Five cases of acute bleeding and two cases of delayed bleeding occurred, with no perforation or stenosis. The complication rate was 5.83% (7/120). At the 6-month endoscopic follow-up, the wound healing rate was 100%. There was no recurrence at the 1-year follow-up. Conclusion: ESD for early gastric cancer and precancerous lesions has the advantages of less trauma, faster recovery, fewer complications, and shorter hospital stay, and is suitable for wide application in hospitals with the necessary conditions.